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Recent evidence indicates that alcohol-induced dysbiosis and increased intestinal permeability promote translocation of bacterial and fungal productssuch as lipopolysaccharide (LPS) and -glucanto the liver, exacerbating inflammatory liver damage 17,40,42

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Additionally, mutations affecting vitamin B 12 transport and intracellular metabolism have been identified (17)

Acknowledgements This study was (partially) supported by the Italian Ministry of Health (Ricerca Corrente 2022 - Fondazione IRCCS C Granda Ospedale Maggiore Policlinico) and by the Italian Ministry of Health (Ricerca Finalizzata - GR-2019-12370172)

The first demonstration of an association between chronic alcohol abuse and ARDS was made by Moss et al, who retrospectively examined 351 patients at risk for ARDS